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Topic: Urgent Care (Read 3175 times)

Hello, I have a physician that's a specialist and he has his own office but he is opening an urgent care and he's not going to be practicing in the urgent care he has hired residence and physician assistant. Correct me if I am wrong but wouldn't be best if we bill everything under the director? However the physician is afraid that his other group npi would be somehow crossed over with the urgent billing and he's not convinced that it would be best to do that? I'm not sure how I can convince the physician to agree to this? Or guarantee him that it wouldn't happen.

My other question? Do all the residence and physician assitant need to be credentialed separate for insurance companies?

The PA and any other providers who will be seeing patients need to be set up with insurance carriers under the urgent care. Is he getting separate EIN/Group NPI for the urgent care? If he is not seeing patients, is he overseeing the PA and resident? Some insurances want the billing done under the PA and others want it done under the physician who supervises them.

Thank you so much for you replying back. yes everything is separate from his other practice. He's listed as the medical director. So will this mess up his own billing for his practice? Yes he's overseeing the resident and PA. How much involvement is he responsible for? So will everything be billed under the urgent care and then we put the resident and pa's npi in box 24 J. Any additional information you can provide me would be helpful and appreciated...

It shouldn't because he should have a separate EIN and a new group NPI for the urgent care. I can't answer for the legal end of what he's responsible for. If the resident and PA are credentialed with the insurance carrier then their NPI can go in 24J but if they are being supervised and the insurance carrier doesn't recognize them independently then the supervising dr's npi goes in 24J.